Factors associated with knowledge level in adult type 1 diabetic patients

Background: The objective of the study is to determine the factors associated with the level of knowledge of Tunisian type 1 diabetic (T1D) patients in adulthood. Methods: This is a cross-sectional study including 93 T1D patients over 18 years old. The knowledge assessment was carried out by a questionnaire rated out of 20 points. The subjects with an „unsatisfactory” level of knowledge (score < 10/20) were compared with subjects whose level of knowledge was „satisfactory” according to their socio-demographic, clinical, and paraclinical characteristics. Results: The mean age of the patients was 37.2 ± 12.4 years. The level of knowledge was „unsatisfactory” in 21 patients (23%). After univariate analysis, an „unsatisfactory” level of knowledge was associated with a low level of education (p = 0.001), a poor socioeconomic level (p = 0.03), a poor glycemic control (p = 0.003) and the absence of self-monitoring (p = 0.002). After multivariate analysis, only a low level of education and a lack of practice of self-monitoring were associated with an „unsatisfactory” level of knowledge (respectively p = 0.03 and 0.03; adjusted OR [95% confidence interval] = 7.3 [1.2–43.5] and 13.7 [1.3–143.3]). Conclusions: The factors independently associated with the level of knowledge in adult T1D patients are the level of education and the practice of self-monitoring. This encourages better tailoring of educational messages to patients with low levels of education and suggests that a better level of knowledge ensures better self-management of diabetes. However, the relationship with the quality of glycemic control remains uncertain.